Answering the call: a tool that measures functional breast cancer literacy

There is a need for health care providers and health care educators to ensure that the messages they communicate are understood. The purpose of this research was to test the reliability and validity, in a culturally diverse sample of women, of a revised Breast Cancer Literacy Assessment Tool (Breast-CLAT) designed to measure functional understanding of breast cancer in English, Spanish, and Arabic. Community health workers verbally administered the 35-item Breast-CLAT to 543 Black, Latina, and Arab American women. A confirmatory factor analysis using a 2-parameter item response theory model was used to test the proposed 3-factor Breast-CLAT (awareness, screening and knowledge, and prevention and control). The confirmatory factor analysis using a 2-parameter item response theory model had a good fit (TLI = .91, RMSEA = .04) to the proposed 3-factor structure. The total scale reliability ranged from .80 for Black participants to .73 for total culturally diverse sample. The three subscales were differentially predictive of family history of cancer. The revised Breast-CLAT scales demonstrated internal consistency reliability and validity in this multiethnic, community-based sample.